What is a Guinea Pig? Plastic Surgery and the Second World War

by Eliza Richardson

“A rodent mammal, originating in South America, but now widely distributed.

The term ‘Guinea Pig’ is applied dialectically to the Wood-Louse and in Cornwall to the small white Cowrie.

A short-legged rodent, having no tail. Or more or less nocturnal habits. Popular as a pet. Numerous breeds obtainable.

A midshipman in the East India Service, for ‘a guinea-pig is neither a pig nor from Guinea, and so a middy is neither a sailor nor an officer.’

“There is obviously on grave omission from the above—a clear and unequivocal definition or description of an East Grinstead Guinea Pig. Can you supply one?[1]

In 1946, the inaugural edition of Guinea Pig printed the above request to its readership. Contemporary readers of the magazine would have no doubt smiled at the tongue-in-cheek of the editors and some may have even provided a definition. Those “Guinea Pigs” represent a notable cohort of Second World War veterans who have become largely forgotten. It was on their bodies that plastic surgery, still in its infancy, was developed. The following will take up the challenge offered by the editors of the Guinea Pig magazine to make a “clear and unequivocal definition” of the Guinea Pigs and their place in Canadian history.

The Guinea Pigs were the wounded airmen who received treatment at the Queen Victoria Hospital in East Grinstead, Sussex, England during the Second World War. The severity of their injuries set them apart from many other wounded servicemen. The increased use of fuel during the Second World War correlated with a larger number of burn victims than ever before. Airmen were particularly susceptible to receiving burns when fires broke out on board during flight or as a result of a crash. Surgeons soon noticed a similarity of injuries amongst burned airmen. The intense dry heat of burning gasoline caused flash burns to the hands, thighs, and face, “as though the entire patient was thrust into a furnace for a few seconds and withdrawn.”[2] So common was this specific pattern of burns that the injury was eponymously named “The Airman’s Burn.”

The airmen, most in their early twenties, often arrived at the Queen Victoria wounded beyond recognition. “Hideous” is not too strong a word to describe their injuries, especially to the face. Given this level of disfigurement, these young servicemen could have safely assumed a lonely existence in the post-war. Luckily for the unfortunate airmen, burn treatment quickly developed over the course of the war. Only thirty years before, most burn victims would not have lived long past their initial injury. Following a severe burn, the body goes into shock and quickly becomes dehydrated as bodily fluids easily evaporate without the skin. In the 1930s, it was discovered that a mixture of saline and plasma would prevent the dehydration and the subsequent death of the burn patient. The physical devastation of the fire, however, remained. It was left to plastic surgeons like Dr. Archibald McIndoe and Dr. Ross Tilley to reconstruct the ravaged faces and bodies of the men of the Allied air forces.

In the 1930s, plastic surgery was not a popular field of medicine, and Dr. McIndoe was one of the few specialists in the world. The field was held in poor regard because many doctors and the public associated it with the quack cosmetic surgeons of the early 20th century. McIndoe, however, was well placed to take over responsibilities at the Queen Victoria. He was related to and had worked with the great plastic surgeon and veteran of the First World War, Sir Harold Gillies, called today the father of modern plastic surgery. While treating airmen during the Battle of Britain in East Grinstead, McIndoe developed a number of new burn treatments. One of the most notable was the saline bath which helped keep patients hydrated, decreased the chances of infection, and assisted the removal of bandages.

Many of the actual surgical techniques used at East Grinstead were modified from the work of Gillies during the Great War. One of Gillies’ key tenets was that reconstruction takes place in stages and patients could require between 5 and 40 surgeries while at East Grinstead.[3] Equally important was ensuring that the body did not reject the grafted skin. One way to ensure this was the use of a tubed pedicle graft. Created by Gillies during the Great War, it was “formed by mixing two parallel incisions, of the required length and distance apart…[and] sewing the edges of the flap together and leaving the extremities undisturbed like a handle on a bag.”[4] This type of graft had a number of benefits. Being attached to the donor site encouraged blood flow to the graft and decreased healing time. Sewing the edges of the grafts together prevented the skin on the edge of the graft from shrivelling. The iconic image of the Guinea Pig to this day is of young men with the pedicle graft in the place of their noses. (For images of Gillies work see the Imperial War Museums collection here).

Photographs of plastic surgery cases from the First World War, at the King George Military Hospital, (later Red Cross Hospital), Stamford Street, London. Photo by Albert Norman. Credit: Wellcome Library, London. Wellcome Images. Creative Commons 4.0.

Unique to East Grinstead was also the attention paid to the morale of the patient.[5] Patients were not allowed to hole themselves away in the hospital and they were encouraged to go into town or even London. Dances and parties were held in the hospital and pretty nurses were hired, a number of whom would even go on to marry their patients. Encouraged by their doctors, patients even came up with their own social club, appropriately named “The Guinea Pig Club,” after one man supposedly commented that “they were probably being used as guinea pigs.” Their surgeons, as the Guinea Pigs well knew, were some of the leading experts in the world, but the humour with which the men faced their injuries remains the most admirable hallmark of the club.

Although men from all nationalities joined The Guinea Pig Club, Canadians were disproportionately represented. At 176 of the 640, they marked the largest non-British segment of the club. Moreover, the Canadian government provided $80,000 for the creation of an all-Canadian wing of the hospital, designed and staffed by Canadians. The head of the wing, Dr. Ross Tilley, would go on to become one of the leading plastic surgeons in Canada. His work at East Grinstead made him an expert in burn treatment, at a time when few really understood it, and upon his return to Canada he was instrumental in getting plastic surgery courses offered for the first time at Queen’s University. The burn centre at Sunnybrook Hospital, the largest trauma centre in the country, was named after him in 1984, and he was the first plastic surgeon to be awarded the Order of Canada. While Ross Tilley was not alone in turning reconstructive surgery into a respected medical field in Canada, the publicity his work at East Grinstead received, helped illustrate that vanity was not the sole reason for plastic surgery.

The Guinea Pig, then, was a horrifically burned airman. But he was more than that, he was also a veteran, a husband, a father, or a member of the workforce. Most of the airmen first arriving at East Grinstead probably thought their injuries would prevent them from leading a normal postwar life. Yet the young men who made up the membership of the Guinea Pig Club were some of the brightest Canadians had to offer and in repairing their bodies and faces, the surgeons of East Grinstead ensured that their injuries would not define who they were following the war.

Eliza Richardson is a PhD student at Wilfrid Laurier University (WLU), currently researching the postwar lives of the Canadian Army Medical Corps Nursing Sisters. She received her BA at McGill University and her MA at WLU. She has worked as a research assistant on the Through Veterans’ Eyes and the Waterloo at War projects and is currently running the Laurier Military Archives alongside Katrina Pasierbek.

[1]The Guinea Pig Magazine, c. 1945, Box. 6A, B2014-0034 John R Taylor World War One and Two Plastic Surgery Collection, B2014-0034, University of Toronto Archives and Records, University of Toronto.